Mucinous tubular and spindle cell carcinoma of kidney: A clinicopathologic study of six cases.

Background: Mucinous tubular and spindle carcinoma (MTSCC) of kidney is a rare, low-grade polymorphic tumor. Recent studies have described a wide morphology spectrum of this tumor. Aim: To report the clinico-pathologic features of six cases of MTSCC of kidney. Materials and Methods: Six cases of MTSCC of kidney were studied and literature was reviewed. Immunohistochemistry was done by Envision method. Results: The age of the patients ranged from 44 to 84 years (mean 58.5 years). Four patients were males and two were females. The tumor was located in the left kidney in four cases and in the right kidney in two cases. The tumor size ranged from 4.5 to 15 cm (mean 6.4 cm). All tumors exhibited an admixture of tubules, spindle cells, and mucinous stroma in variable proportions. Tubules were predominant in five cases and spindle cells in one case. Psammomatous calcifications, papillations, and necrosis were seen in two cases. Collections of foamy histiocytes were noted in four cases. Cytoplasmic vacuoles and osseous metaplasia were seen in one case each. All cases were Fuhrman's nuclear grade II. Five cases were of stage pT1, and one was pT3. All cases stained positive for alcian blue at pH 2.5. Immunohistochemical stain CK7 was positive in all cases and CD10 was positive in 1/1 case. All patients were alive and well at follow-up of 12-59 months (mean 33.5 months). No metastases were detected. Conclusions: We report six cases of MTSCC of kidney, a rare distinct variant of RCC, with a favorable prognosis. A male predominance was seen in our cases. MTSCC shares histologic and immunohistochemical overlap with papillary renal cell carcinoma (PRCC) and cytogenetic analysis should be performed in difficult cases to avoid a misdiagnosis.

Ureteric nephrogenic adenoma: A report of two cases.

Nephrogenic adenoma is a rare, benign, metaplastic lesion predominantly seen in urinary bladder, which occurs even more rarely in the ureters. We report two such cases, arising in the ureter. Both patients were young adult males. Histology of both cases was similar, showing tubules lined by columnar cells with hobnailing of nuclei. Immunohistochemically, both cases resembled their counterparts in urinary bladder. These lesions are important to recognize, since they can easily be confused with several malignancies.

Study of parameters to ensure quality control in histopathology reporting: A meta-analysis at a tertiary care center.

Context : When surgical pathology reports are dispatched to patients and clinicians, sometimes they are discovered to have errors, and it is a common practice for the pathologists to issue amended reports. Measuring the rate at which surgical pathology reports are amended can be used as a tool for assuring quality control in histopathology. Aim : The aim of this study was determine the parameters that can be used as an assessment tool to minimize errors in histopathology. Materials and Methods : This study was carried out at a major histopathology center. The duration of this study was from January 2001 through January 2011(ten years). Following parameters were looked for: Interpretational errors, permanent and frozen section correlation, intradepartmental consultation and cases sent for second opinion, cases brought in tissue committee meetings, audits, and cases discussed in hospital meetings. Results : A total of 28,1931 surgical pathology cases were signed out during the ten-year period. On these, addendums were issued on 5730 cases (2.0%). Additional report issued on 3521 (1.3%). Addendum/corrected report issued for 2209 cases, which was 0.7%, representing the true interpretational error. And out of this number, a second opinion was taken for 5980 cases, and 78 were sent abroad for second opinion. Conclusion : Review by a second pathologist is a strong tool to minimize errors in surgical pathology reporting. This may be done prior to or after the report is dispatched and the case is discussed in the hospital for treatment purposes. This analysis concludes that true interpretational error occurred only in 0.7% of cases, which is an attribute to the strong peer review in the department.